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1335313 <br /> CURRENT LOCATION INFORMATlON,4 nciuding city;;state;ZIP) <br /> Current location: tL_t } ( <br /> t Cs_e_Al'fl;4-k.A, 1' L.l.�l _\To.oe a 1.,13:x=2 County: /Ann <br /> [Dealer lot Dealer name: nC^ ` <br /> l y��L � ���lt n t� \,3,11,1,_.) <br /> t <br /> Dealer license number: SI) !qb <br /> [Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> IF BEING MOVED,1LOCATION.CHANGESIncludin <br /> ( g city,�stafe;ZIP) `� <br /> New location: i- 1(, p ] C 4 Rc� $C 'I"vY5leYlll t%!73 nr t z County: ,ttrtoo <br /> [Dealer lot Dealer name: I Dealer license number: <br /> [Park name(if applicable): <br /> Out-of-state/federal or tribal property location: <br /> OWNER <br /> Current owner names: <br /> I - <br /> Are you changing the name of an existing owner? [Yes�/ No <br /> Changing from: to: <br /> Home transfer by inheritance? [Yes No If yes,attach appropriate Inheritance Affidavit(Form 2946 or 5177) <br /> Home transfer due to foreclosure? fl Yes f No If yes,attach Affidavit of Repossession(Form 3926) <br /> Home transfer through abandonment process? [i]Yes Z No If yes,attach Abandonment Affidavit(Form 2951) <br /> Home transfer through divorce,trust,or right of survivorship? [Yes V]No If yes,attach Change Affidavit <br /> (Form 5221) <br /> BUYER/NEW OWNER INFORMATION (one name pet box) <br /> Bil ger/nervi owner name Last,first middle): ,er name(Last,first, middle): <br /> Mailing address: Mailing address: <br /> i ¶3< j ��uvt SE (vYy,eft0 X7392 2 Pi sa,o,At <br /> Phone number: SIZ wct9- frZ' - Phone number:sea-9eig _a i I t <br /> Email address: Email address: <br /> Buyer/new owner name(Last,first, middle): Buyer/new owner name(Last,first, middle): <br /> Mailing address: Mailing address: <br /> 3 4 <br /> Same as above [Same as above <br /> Phone number: Phone number: <br /> Email address: Email address: <br /> 440-2952(7/17/COM) <br /> OR Title Application-10/2018-TitleApp11211 Page 3 004175519-00001 <br />